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Bevacizumab Surgery Timing — SCE Medical Oncology MCQ

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HardOncological EmergenciesBevacizumab Surgery TimingSCE Medical Oncology

A patient receiving bevacizumab develops a confirmed gastrointestinal perforation and undergoes emergency surgery. The wound is fully healed six weeks later and the cancer remains bevacizumab-sensitive. What is the SmPC-compliant bevacizumab decision?

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Correct answer: E — Permanently discontinue bevacizumab after gastrointestinal perforation

The Avastin SmPC requires permanent discontinuation after gastrointestinal perforation. The separate rule not to initiate for at least 28 days after major surgery or until a wound is healed does not authorise rechallenge after perforation. Dose reduction and schedule changes are not validated ways to negate this toxicity.

Reference: Avastin UK SmPC. https://www.medicines.org.uk/emc/product/3885/smpc